Hiromoto Atsushi, Sakamoto Shun-Ichiro, Miyagi Yasuo, Nitta Takashi
Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Surg Case Rep. 2019 Jan 4;5(1):2. doi: 10.1186/s40792-018-0558-5.
Surgery for infective endocarditis involving the aorto-mitral curtain (AMC) is challenging and requires extensive incisions and complex reconstruction procedures. However, in patients with preserved aortic annulus, reconstruction of the AMC is possible using a simple technique with limited incisions.
A handmade bovine three-portion pericardial patch was used to reconstruct the AMC in a patient with severe endocarditis requiring double valve replacement; the technique allowed for steady anchorage of prosthetic valves without additional incisions other than conventional aortotomy and atriotomy. Postoperative echocardiography revealed normal cardiac function and no significant perivalvular leakage. The patient displayed complete recovery and was discharged on postoperative day 33. The patient was symptom-free at his 1-year follow-up and displayed normal laboratory and echocardiographic findings.
The bovine three-portion pericardial patch is useful for reconstructing the AMC in patients with infective endocarditis accompanied by preserved aortic annulus.
涉及主动脉二尖瓣间隔（AMC）的感染性心内膜炎手术具有挑战性，需要广泛的切口和复杂的重建程序。然而，对于主动脉瓣环保留的患者，使用有限切口的简单技术重建AMC是可行的。
在一名需要进行双瓣置换的严重心内膜炎患者中，使用手工制作的牛心包三部分补片重建AMC；该技术允许人工瓣膜稳定固定，除了传统的主动脉切开术和心房切开术外无需额外切口。术后超声心动图显示心脏功能正常，无明显瓣周漏。患者完全康复，术后第33天出院。患者在1年随访时无症状，实验室检查和超声心动图结果正常。
牛心包三部分补片对于伴有保留主动脉瓣环的感染性心内膜炎患者重建AMC是有用的。
